Cuts for mental health, drug treatment have many nervous

The biggest-ever reduction in mental health and drug treatment funding passed by the Florida Senate this week will cost taxpayers even more in jails, hospitals and police if it goes forward, some say.

By Anne GeggisStaff writer

The biggest-ever reduction in mental health and drug treatment funding passed by the Florida Senate this week will cost taxpayers even more in jails, hospitals and police if it goes forward, some say.But this area's state senator said it's time to turn to cheaper means of delivering care, given the state's cash crunch.Florida is 50th among the states and the District of Columbia -- only Texas spends less -- when funding for mental health agencies like Meridian Behavioral Healthcare is measured on a per-capita basis, according to the Kaiser Family Foundation, a nonpartisan, health policy not-for-profit think tank.The state Senate wants to reduce state funding for those services by 25 percent -- about $83 million -- next year, which concerns doctors, law enforcement, homeless advocates and prison officials alike.“It's going to make a bad situation worse,” said Dr. Gary Gillette, an emergency room physician at North Florida Regional Medical Center. “I deal with it on a daily basis, and it's been getting worse.”“There are less and less places for them (those with mental issues and substance abuse problems) to get care,” he added.Faced with a budget shortfall of more than $1 billion, the state House has proposed cuts that would hit nursing homes, while the Senate has opted to reduce state spending on drug treatment and mental health services.Details of how the Senate's proposed cut would affect Meridian, the area's largest provider of mental health and drug treatment services to those with little or no insurance, haven't been released yet. But supporters say such a cut and the resulting reduction in services at the agency based on Southwest 13th Street would ripple throughout the area.“I can't predict the future, but what I can say is we do work closely with Meridian …,” said Lt. Whitney Stout, who supervises the Gainesville Police Departmentt's crisis intervention team. “And as their services are cut, people who suffer from mental illnesses are going to have more crises, and it's going to lead to more calls to the police.”

THE BEST OF BAD OPTIONS?Sen. Steve Oelrich, R-Cross Creek, said he agrees with his Senate colleague, Joe Negron, the Stuart Republican in charge of the state's health care budget, that the House's proposed cuts hurt nursing home residents who need the state's help through no fault of their own.He said he doesn't agree with Negron's thinking that the elderly and disabled should have priority over the needs of mentally ill adults, however.“I've done law enforcement for 30 years, and not dealing with the mentally ill can overload the system,” he said.For drug treatment, though, he said he'd like to see the state boost options that are less costly to taxpayers, such as Narcotics Anonymous and Alcoholics Anonymous. These programs have great track records, he said.“We're doing triage here,” he said. “We only have a certain amount of money, and we have to pick what groups don't get that money and what groups get half of what they used to get.”But Maggie Labarta, president and chief executive officer of Meridian, said programs through NA and AA, while highly successful, do not include treatment.“Many people who are successful in these 12-step groups have already participated in treatment,” she said. “What makes effective drug treatment is engagement, structure and evidence-based practices.”Labarta said that already, with the capacity Meridian has, there are more than 100 waiting for drug treatment services and nearly 200 waiting for mental health services, including beds. Her agency is the last resort for these people -- outside of prison, shelters or hospitals, she said.“Either population, if you start to erode the safety net -- already the most threadbare in the country -- they'll have no place to turn without costing the system even more,” she said. “Lives that could have been rich and full will be lost.”

SYSTEMIC COSTSAmong those who encounter the casualties of drugs and mental illness, there's widespread agreement that cuts like these could be costlier in the long run.Art Forgey, public information officer at the Alachua County Sheriff's Office, said he's hearing stories unlike any others before -- such as the one about a man in Palm Beach County who has been held in custody under the state's Baker Act 50 times in the past year because of the danger he presented to himself or others. That means the man was continually put into the situation where treatment costs the most -- an emergency, he said.“It's almost impossible to get a person with a severe and persistent mental illness into a psychiatric bed,” Forgey said. “At some point, we have to ask ourselves, what is the point that we'll reach that we can no longer get by? I think we're getting there.”His sentiments are echoed at the Gainesville Police Department and at the city homeless shelter, St. Francis House.A draft report for the Florida College of Emergency Physicians from the University of South Florida faculty shows that the number of people with psychiatric diagnoses -- including drug overdoses -- who were admitted to Florida's hospitals has increased nearly 25 percent between 2006 and 2010.

ONE WOMAN'S STORYDuring Katrina McSpadden's 11-year addiction to opiates, which she calls “roxies,” she was admitted to the hospital 10 times for overdoses, including one occasion in which she spent 16 days on life support, she said.The 40-year-old Lake Butler grandmother said she fell into addiction as a result of the pain medicine she received after numerous surgeries following a fall that injured both shoulders and her back.“None of them (the overdoses) were suicide attempts,” said the former housekeeper, who is now collecting disability. “They were all just taking too much of this and too much of that.”McSpadden has been coming to Meridian's methadone clinic for seven months now, with no problems. Because of state funding, the clinic is able to offer more supportthan for-profit methadone clinics typically do.“I'm still in pain, but now I can be with my kids and my grandbaby,” she said.Her daughter, Cortney McSpadden, 20, who found her mother unresponsive a few times, assesses the situation more bluntly.“She's not running the roads, getting in trouble,” she said. “If it wasn't for the (Meridian) clinic, she would be dead.”This week, the House and the Senate committees will be negotiating to reach a final budget deal for funding state programs ranging from Medicaid to the state's higher learning institutions.